    <div class="container">
      <div class="bg-putih">

        <div class="jdl-page">
          <?php echo isset($judul)?$judul:'<font color="#ccc">Judul Belum Diberikan</font>'; ?>
          <div class="clearfix"></div>
        </div>

        <?php echo form_open(uri_string(), array('class' => 'form-horizontal', 'role' => 'form', 'id' => 'form')); ?>
        <input type="hidden" name="KdObatHilang" value="<?php echo $data['KdObatHilang']; ?>">
        <div class="form-group">
          <label class="col-xs-2 control-label">Nama Obat</label>
          <div class="col-xs-10">
            <script type="text/javascript">
             $(document).ready(function() {
              $("#obat").select2();
            });
           </script>
           <select id="obat" class="form-control input-sm" name="obat">
            <?php  
            $klpk_getter = $this->db->get('obat');
            $res_klpk_getter = $klpk_getter->result_array();
            foreach($res_klpk_getter as $klkpk_obat):
              ?>
            <?php if($klkpk_obat['KdObat'] == $data['KdObat']): ?>
              <option value="<?php echo $klkpk_obat['KdObat'] ?>" selected="selected"><?php echo $klkpk_obat['NmObat'] ?></option>
            <?php else: ?>
              <option value="<?php echo $klkpk_obat['KdObat'] ?>"><?php echo $klkpk_obat['NmObat'] ?></option>
            <?php endif; ?>
            <?php
            endforeach;
            ?>
          </select>
        </div>
      </div>
      <div class="form-group">
        <label class="col-xs-2 control-label">Tanggal<br/>(dd-mm-yyyy)<span style="color:red;">*</span></label>
        <div class="col-xs-4">
          <input type="text" name="tanggal" id="tanggal" class="form-control input-sm" value="<?php echo id_date($data['Tanggal'],'short') ?>">
        </div>
      </div>
      <div class="form-group">
        <label class="col-xs-2 control-label">Jumlah</label>
        <div class="col-xs-10">
          <input type="text" name="jmlh" value="<?php echo $data['Jumlah']; ?>" class="form-control input-sm" placeholder="">
        </div>
      </div>
      <div class="form-group">
        <label class="col-xs-2 control-label">Keterangan</label>
        <div class="col-xs-10">
          <textarea name="ket" id="ket" class="form-control input-sm" rows="3"><?php echo $data['Keterangan']; ?></textarea>
        </div>
      </div>
      <div class="form-group">
        <div class="col-xs-offset-2 col-xs-10">
          <button type="submit" class="btn btn-primary btn-sm">Perbaharui</button>
          <button type="reset" class="btn btn-default btn-sm">Kosongkan</button>
        </div>
      </div>
      <?php echo form_close(); ?>

      <div class="clearfix"></div>
    </div>
  </div> <!-- /container -->

  <script>
    $("#form").validate({
      rules: {
        nama: {
          required: true,
          minlength: 3
        },
        ket: {
          required: true         
        }
      }
    });
  </script>

  <script type="text/javascript">
      $(document).ready(function(){
        $('#tanggal').datepicker({
          dateFormat: "dd/mm/yy",
          changeMonth: true,
          changeYear: true
        });
      });
    </script>